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2015 ; 13
(1
): 28
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Tobacco and end stage renal disease: a multicenter, cross-sectional study in
Argentinian Northern Patagonia
#MMPMID26327820
Alba MM
; Citarelli AN
; Menni F
; Agricola M
; Braicovich A
; De Horta E
; De Rosa F
; Filanino G
; Gaggiotti R
; Junqueras N
; Martinelli S
; Milan A
; Morales ME
; Setti S
; Villalba DO
Tob Induc Dis
2015[]; 13
(1
): 28
PMID26327820
show ga
BACKGROUND: Smoking and chronic kidney disease are major public health problems
with common features -high prevalence and mortality, high cardiovascular risk,
gender differences and high prevalence in low income people-, but the link
between them is poorly recognized. Our objectives were to investigate the
exposure of dialysis patients to tobacco and to know their smoking behavior.
METHODS: We performed a multicenter, cross-sectional study in nine dialysis units
in the Argentinian Northern Patagonia. We investigated smoker status, lifetime
tobacco consumption, current tobacco use, breath carbon monoxide and %
carboxyhaemoglobin. Fagerström and Richmond tests were performed for active
smokers. STATISTICAL ANALYSIS: one way ANOVA and Tukey's test for post hoc test.
For exploratory analysis, frequency tables through chi-square distribution and
single correspondence analysis were performed. RESULTS: Six hundred thirty six
patients (60.9 % males, 39.1 % females) were interviewed. Almost 70 % of them had
had tobacco exposure. Excluding light smokers, the lifetime consumption was
significantly different (p?=?0.0052) between sexes (33.1?±?2.4 pack/years in
males and 18.2?±?2.1 pack/years in females) The distribution of etiologies
changed significantly (? (2) p?0.0001) with smoker status and the dose of
tobacco smoking, with an increase in the diagnosis of nephrosclerosis in patients
with high and very high lifetime consumption (from 16.1 % in non-smokers to 28.2
and 27 % respectively), and in passive smokers (from 16.1 to 27.3 %). The male
preponderance of end-stage renal disease disappeared when only non-smokers were
considered and grew with the increase in the lifetime consumption. Active smokers
have small consumption, both low CO level and % COHb, low dependence and a good
motivation to quit, but a high lifetime consumption. CONCLUSIONS: Exposure of
dialysis patients to tobacco is high and could be related to the progression to
the final stage of the renal disease. It seems that tobacco renal damage is
mostly hidden in the diagnosis of nephrosclerosis. The gender difference observed
in these patients could also have a nexus with the men's higher tobacco exposure.
Active smokers have a low current consumption but a high lifetime tobacco dose.